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Monday, January 12, 2009

Why are veterans walking alone?



by
Chaplain Kathie
They were carried by their brothers in Vietnam when they were wounded. They marched into hell together. Supplied by the government to wage war with the weapons they needed to defeat the enemy, they did what was expected of them. Some did it because they believed in the mission they were sent on. Some did it because they believed their brothers would have their backs. They walked and fought side by side, but when they came home, they walked alone and the new enemy was the Department of Veterans Affairs.

As VA evaluates the evidence gathered, it must apply rules from an extensive body of laws, regulations, court rulings and internal policy manuals. There are more than five dozen separate steps in evaluating a veteran's initial disability compensation claim, and VA itself may wait two or three months to receive information requested of other federal agencies and private sources with medical records. One step that generally contributes significantly to processing time is the search for old military records, particularly medical records. Finding evidence that a condition first was noted when someone received care in the military health care system can be important to determining an official connection with his or her service.

In a small percentage of cases, the old military records needed by veterans must be retrieved from the National Archives and Records Administration, an independent federal agency. It holds millions of military personnel and health records of discharged and deceased veterans for the last century at its National Personnel Records Center in St. Louis, Mo. As part of its efforts to expedite claims processing, VA has put some of its own personnel at the St. Louis center to supplement the National Archives staff. On average, VA waits 122 days for the St. Louis center to locate and forward requested records.




Over and over as their claims were being denied, they were told that it was up to them to prove their claim was worthy of their seal of approval. They handed over their DD214, all the records they had and even the pictures they had taken. Then they were asked for more. Records could not be found, witnesses were scattered across the nation and they discovered they were considered as lying until proven truthful.

Search for Records Delays Claims Development

When veterans apply for disability compensation, they are asked to provide medical evidence of a current condition and evidence that would relate it to the time of service. VA currently is expanding its role in providing assistance in requesting records and gathering additional evidence to demonstrate the connection with military service as well as current evidence of disability. This includes providing the veteran a medical examination. In addition, VA works closely with private nonprofit veterans organizations that have trained staff members assist veterans with their claims. Under federal law, the burden ultimately is on the veteran to demonstrate a "service connection" for a disability.




These men and women, rare as they are, were willing to lay down their lives for the sake of this nation. Does the VA understand how noble this is? How can they possibly think that the majority of them are lying about their service or their wounds? How can a person go from being willing to surrender their very life for the nation into a low life looking for free money? Does it happen? Absolutely but the vast majority turn to the VA reluctantly.



May 19, 2005
A Office of Inspector General Washington, DC 20420
Report No. 05-00765-137


Ratings for PTSD. During FYs 1999–2004, the number and percentage of PTSD cases increased significantly. While the total number of all veterans receiving disability compensation grew by only 12.2 percent, the number of PTSD cases grew by 79.5 percent, from 120,265 cases in FY 1999 to 215,871 cases in FY 2004. During the same period, PTSD benefits payments increased 148.8 percent from $1.7 billion to $4.3 billion. Compensation for all other disability categories only increased by 41.7 percent. While veterans being compensated for PTSD represented only 8.7 percent of all compensation recipients, they received 20.5 percent of all compensation payments.


Lump sum to reduce "workload" and money.

Lump-Sum Payments. In 1997, as part of an overall strategy to improve claims processing timeliness, we suggested that VBA could offer lump-sum payments to veterans to reduce the number of reopened claims. Taking into consideration that 30.6 percent of all claims are rated 10 percent, combined with results from our survey where rating specialists expressed concern with insufficient staff to adequately process claims, consideration should be given to offering lump-sum payments to veterans as settlement of all future compensation cases. Lump-sum payments for all veterans with disabilities rated 20 percent or less would result in reducing 46.9 percent, or 1.17 million active claims. It would also result in reducing recurring compensation payments of $1.96 billion a year and would free up staff to improve the quality and timeliness of future workload. Acceptance of a lump-sum payment would not change a veteran’s eligibility for VA health care.

The VA put this out saying by 2001 they would have increased claim reps by 1,000, but this was before Afghanistan and before Iraq.

Increasing Claim Complexity Prompts Quality Controls, Training

Each year, VA receives more than 100,000 new disability compensation claims. With improved benefits information and outreach, veterans today are filing claims for more conditions than at any time in history. By the end of fiscal 2001, VA expects to have 1,000 more employees working on claims than the 5,500 in fiscal 1999.



PTSD Case Reviews

We reviewed 2,100 compensation cases at 7 VAROs and found VBA procedures were not always followed, and that VAROs approached stressor verification requirements differently from state to state. In 527 (25 percent) of the 2,100 cases reviewed, we found inconsistencies in the methods raters used to develop and verify veteran-reported evidence about the claimed service-related stressor event before granting compensation benefits. The error rate ranged from a low of 11 percent in Oregon to a high of 40.7 percent in Maine. The error rate for Illinois was 21.7 percent. To demonstrate the potential consequence of not obtaining or developing adequate evidence to support a PTSD claim, the 25 percent error rate equates to questionable compensation payments totaling $860.2 million in FY 2004. Over the lifetimes of these veterans, the questionable payments would be an estimated $19.8 billion.
Our review at three VAROs revealed that the STAR program was ineffective in detecting the evidence development weaknesses identified in our review of PTSD cases. We determined that veterans sought less treatment for PTSD when their ratings were increased to 100 percent. Of 92 PTSD cases reviewed, we found that 39 percent had a decline in mental health visits after achieving 100 percent status. The average decline in visits was 82 percent, with some veterans receiving no mental health treatment at all.
Part of the problem is that the compensation program has a built-in disincentive to get well when veterans are reapplying to get their disability ratings increased.

The issue here is not that they did not want to get well. They were already aware they would never be cured and that the programs the VA had would only keep them stable. Many Vietnam veterans go for therapy and medication to stay stable. It is not until another stressor comes into their lives and they need additional help they once again turn to treatment.

My husband has an approved 70-30 claim. 70 percent for PTSD and 30 for un-employability. He is still going to the VA for treatment because when he stops going, he begins to slide back again. During the years as the newer veterans entered into the system, his appointments were cut back several times. His doctors noticed that the appointments needed to be increased back to at least monthly visits and he was once again stable.

How many other veterans do not have doctors making efforts to make sure the visits are appropriate to the level of care needed? Is the figure of veterans receiving no mental health care due to their not wanting it or more an availability issue? Consider that some PTSD veterans are able to still work cannot keep taking time off work to go to the VA and that some veterans live too far away from the care they need causing hardships trying to get to the help. Ever see a Vets Center without veterans seeking help? Most of the centers are able to see veterans in need when the VA hospitals are too far away for them to go to. It's another reason why the Veterans Centers need to be up and running in every state to take care of the veterans living too far away from medical care.


They already had a problem and they knew it. They didn't act to fix it with the new veterans coming in.


There is a very small percentage of claims that are not real. Much of the problem addressed in this report stated the problem was not fraud in the claim itself but incomes that were not reported. That did not mean the claim itself was fraud. Yet months and years after a veteran seeks help from the VA, they are put through hell trying to get it. At the same time, they have bills to pay and families to take care of but they have no income to do it with. They are forced to fight the government for what? For doing what few others in this country were willing to do? For doing their duty and ending up wounded for doing it?

We have more veterans in this country that have never sought any kind of help from the VA, yet the VA is unable to take care of the veterans that do seek help and compensation. We are a nation of over 300 million people yet we cannot take care of the less than 24 million veterans needing the help of the government.

So why are they and their families fighting the government alone? Why are they still waiting for help, feeling as if the entire nation has forgotten they even exist? When do we fight for them? When do we demand all veterans receive the care they were assured would be there if they needed it? When do we demand the over 800,000 claims in the backlog pile get processed and the hundreds of thousands of claims on appeal be done? The veteran has a timeline to meet but the VA does not. They can take all the time in the world to honor a claim. They can and do finally approve claims at lower ratings than the veteran qualifies for. Why else would requests for additional ratings end up being honored if they did not qualify for them in the first place?

There are groups all over this country trying to help the veterans but they have a go-it-alone attitude without joining forces and memberships to petition the government and congress to get this right right now! This is all going to get worse for our veterans unless this is about the veterans having to fight battles after the battles they were sent to fight have been finished.

Today they still end up being pushed out and pushed back. They end up without money and without care. They end up homeless. They end up in jail because they lost hope and feel used and abused by the same nation they were willing to die for. Ask the veterans, even the ones that feel betrayed by the government, if they would do it again and they would still risk their lives. We should hang our heads in shame because they cannot hold their heads up high knowing they were worthy of every effort to us to make sure they were taken care of. Why should they walk alone now?

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